# BIRTH FLETCHER ORAL SURGERY KELLER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053743518
- **Authorized official:** DR. CRISTI FLETCHER DDS, MS (ORTHODONTIST)
- **Authorized official phone:** (817) 479-0541

## Contact information

- **Practice address:** 4420 HERITAGE TRACE PKWY STE 300, FORT WORTH, TX 76244-8904
- **Practice address phone:** (817) 479-0541
- **Mailing address:** 4420 HERITAGE TRACE PKWY STE 300, FORT WORTH, TX 76244-8904
- **Mailing address phone:** (817) 479-0541

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 19486 | TX | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 22279 | TX | — |

## Other

- **Enumeration date:** 08/06/2013
- **Last updated:** 11/04/2013